title: Renal mass with caval thrombus as atypical presentation of xantogranulomatous pyelonephritis. A case report and literature review.
abstract: BACKGROUND
  Xantogranulomatous pyelonephritis is a rare, severe, chronic renal infection typically resulting in diffuse renal destruction. Enlarged kidney is typical radiological finding. In this work we describe an extremely rare case in which a clinically classified cT3b Tumor (level II IVC thrombus) was detected; at specimen analysis to be xantogranulomatous pyelonephritis with IVC extension.
  
  
  METHODS
  U.V., female, 86 years old, we diagnosed with right renal mass, with extension to IVC. By pathological analysis, it was found that renal mass and the thrombus was not due to RCC, but by xantogranulomatous pyelonephritis.
  
  
  CONCLUSIONS
  Xantogranulomatous pyelonephritis with IVC thrombus is exceptional and has been described in 4 cases. Such a diagnosis could have anesthesiologic importance, in particular related to antimicrobial treatment. Xantogranulomatous pyelonephritis has its own classification, based on extension and organ involvement, but this case fall out of current classification.
  
  
  CONCLUSIONS
  This possibility could be suspected and updating of disease's classification could be suggested.
authors.affiliation: Division of Urology, University of Brescia-Spedali Civili Hospital, Brescia, Italy. dr.arrighi@live.it
authors.forename: Nicola
authors.initials: N
authors.lastname: Arrighi
authors.forename: Alessandro
authors.initials: A
authors.lastname: Antonelli
authors.forename: Danilo
authors.initials: D
authors.lastname: Zani
authors.forename: Tiziano
authors.initials: T
authors.lastname: Zanotelli
authors.forename: Serena
authors.initials: S
authors.lastname: Corti
authors.forename: Sergio Cosciani
authors.initials: SC
authors.lastname: Cunico
authors.forename: Claudio
authors.initials: C
authors.lastname: Simeone
mesh_terms: D000369:Aged, 80 and over; D005260:Female; D006801:Humans; D011705:Pyelonephritis, Xanthogranulomatous / Q000150:complications* / Q000175:diagnosis; D013927:Thrombosis / Q000209:etiology*; D014682:Vena Cava, Inferior